Humans ; COVID-19/complications* ; Ischemia ; Arterial Occlusive Diseases ; Peripheral Vascular Diseases

Acute arterial occlusion is a rare complication following total knee arthroplasty (TKA). The incidence as reported previously is from 0.03% to 0.17%; however, the sequelae can be disastrous because of its potential threat to limb loss.We report a case of acute arterial occlusion in the midpiece of femoral artery following TKA occurred 40 min postoperatively. The occlusion site existed at the midpiece of femoral artery is uncommon. Arterial circulation of the lower limb could not be restored by the thrombolysis and thrombectomy treatments performed within 11 h after TKA. In the end, amputation had to be carried out. In the treatment of acute arterial occlusion following TKA with a tourniquet, it is important to fully consider that arteriosclerosis may induce atheromatous plaque disruption, which might be the reason for acute arterial occlusion.
Amputation ; methods ; Angiography ; methods ; Arterial Occlusive Diseases ; etiology ; surgery ; Arthroplasty, Replacement, Knee ; adverse effects ; methods ; Disease Progression ; Female ; Femoral Artery ; diagnostic imaging ; surgery ; Follow-Up Studies ; Humans ; Middle Aged ; Osteoarthritis, Knee ; diagnostic imaging ; surgery ; Postoperative Complications ; diagnosis ; surgery ; Severity of Illness Index ; Thrombectomy ; methods ; Thrombosis ; diagnostic imaging ; etiology ; surgery

From January 2008 to January 2013, 11 patients with central renal tumors underwent ultrasound-guided open nephron sparing surgery (ONSS) without renal artery occlusion. We removed the lesions, and the cut edges of the tumors were negative. Thus, we deduced that ultrasound-guided ONSS is suitable for the cases with obscure tumor boundary or multiple lesions. It could achieve the purpose of thoroughly removing lesions, as well as to expand the application range of nephron sparing surgery.
Arterial Occlusive Diseases ; etiology ; prevention & control ; Carcinoma, Renal Cell ; surgery ; Female ; Humans ; Kidney Neoplasms ; surgery ; Male ; Nephrons ; surgery ; Postoperative Complications ; Renal Artery ; pathology ; surgery ; Surgery, Computer-Assisted ; adverse effects ; methods ; Ultrasonography

OBJECTIVETo compare mid-term results of surgical treatment with aortoiliac stenting (AIS) in patients with chronic aortoiliac occlusion.

METHODSA retrospective review of 68 patients treated between January 2005 and December 2010 was performed. Thirty-three patients underwent surgical revascularization (surgical group) and 35 patients underwent AIS (AIS group). Preoperative clinical factors and outcome data including complications, ankle-brachial index and mortality were collected. Kaplan-Meier estimates for survival, limb salvage and patency were analyzed.

RESULTSPreoperative risk factors were similar between the two groups. Surgical group were younger than AIS group ((56±11) years vs. (65±10) years, t=-2.789, P=0.008) with more patients manifesting rest pain (23/33 vs.15/35, χ2=4.963, P=0.026) and relative higher perioperative mortality (3/33 vs. 0/35, P=0.109). Mean ankle-brachial index increased significantly in both groups after operation (Surgical group 0.90±0.15 vs. 0.43±0.20, t=-7.849, P=0.000; AIS group 0.85±0.20 vs. 0.41±0.25, t=-5.379, P=0.000). Postoperative complications occurred, with statistically higher rates of respiratory failure, transient renal dysfunction and multiple organ dysfunction syndrome in surgical group (χ2=6.98, P=0.010; χ2=9.62, P=0.000; P=0.023). The 5-year primary patency in surgical group was 90.2%, compared with 64.2% in AIS group (χ2=3.717, P=0.054). No difference was observed in survival rate, limb salvage and secondary patency between the two groups.

CONCLUSIONSFive-year primary patency of endovascular reconstruction for chronic aortoiliac occlusion is lower than that for traditional open surgery. Open surgery is still the first choice for the patients who can endure the surgery. Endovascular treatment is an option for patients with high risk. However, additional interventional treatment is needed in some cases.

Adult ; Aged ; Arterial Occlusive Diseases ; surgery ; Humans ; Limb Salvage ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Stents ; Survival Rate ; Treatment Outcome ; Vascular Patency ; Vascular Surgical Procedures

Median arcuate ligament syndrome is an anatomic and clinical entity characterized by dynamic compression of the proximal celiac artery by the median arcuate ligament, which leads to postprandial epigastric pain, vomiting, and weight loss. These symptoms are usually nonspecific and are easily misdiagnosed as functional dyspepsia, peptic ulcer disease, or gastropathy. In this report, we presented a 72-year-old male patient with celiac artery compression syndrome causing recurrent abdominal pain associated with gastric ulcer and iron deficiency anemia. This association is relatively uncommon and therefore not well determined. In addition, we reported the CT angiography findings and three-dimensional reconstructions of this rare case.
Abdominal Pain/*etiology ; Aged ; Anemia, Iron-Deficiency/*etiology ; Angiography/methods ; Arterial Occlusive Diseases/radiography ; Celiac Artery/*abnormalities/radiography ; Constriction, Pathologic/complications/*radiography ; Diaphragm ; Humans ; Male ; Recurrence ; Stomach Ulcer/complications/*radiography ; Syndrome ; Tomography, X-Ray Computed ; Weight Loss

We report the case of a 41-year-old Chinese woman with Behçet's disease (BD) complicated by acute myocardial infarction, requiring inotropic and ventilatory support. Angiography showed critical left anterior descending coronary artery stenosis, a blocked left subclavian artery and left carotid artery stenosis. The patient was successfully treated with a high dose of immunosuppressants, standard anti-ischaemic therapy and percutaneous coronary intervention. Although life-threatening, coronary arteritis is a treatable manifestation of BD. We suggest that the diagnosis of coronary arteritis be considered in patients with BD who present with chest pain. Involvement of other arteries should also be looked out for in these patients.
Adult ; Angiography ; Angioplasty, Balloon, Coronary ; Arterial Occlusive Diseases ; physiopathology ; Arteritis ; physiopathology ; Behcet Syndrome ; complications ; Coronary Angiography ; Coronary Vessels ; physiopathology ; Female ; Humans ; Infarction ; complications ; Inflammation ; physiopathology ; Magnetic Resonance Imaging ; Myocardial Infarction ; complications ; Prednisolone ; therapeutic use ; Subclavian Artery ; pathology ; physiopathology

No abstract available.
Arterial Occlusive Diseases/complications/*diagnosis/radiography ; Hemorrhage ; Humans ; Ileal Diseases/radiography/surgery ; Ileocecal Valve/blood supply ; Infarction/pathology/*surgery ; Male ; Mesenteric Artery, Superior/*radiography ; Middle Aged ; Thromboangiitis Obliterans/complications/*diagnosis ; Tomography, X-Ray Computed

OBJECTIVETo discuss the cause and treatment of acute limb ischemia in endovascular therapy of the lower extremity arterial occlusive disease.

METHODSClinical data of 54 cases of acute limb ischemia in the endovascular treatment of 685 cases of lower extremity arterial occlusive disease from June 2003 to April 2012 was analyzed retrospectively. There were 43 male and 11 female patients, with a mean age of 72.3 years (ranging from 56 to 82 years). The major causes which resulted in acute limb ischemia included: arterial embolization of 43 cases, arterial thrombosis of 8 cases, arterial dissection of 3 cases. The acute limb ischemia occurred in the process of balloon angioplasty/stent in 36 cases, catheter-directed thrombolysis in 17 cases, Silverhawk atherectomy in 1 cases. Thirty-two cases were treated by endovascular treatment, 9 cases by surgical procedures (bypass or embolectomy), 13 cases by the combination of endovascular therapy and surgical procedures.

RESULTSTreatment were successfully accomplished in 50 of 54 cases, and failed in 4 cases which had surgical amputation. There were no deaths in all the patients. Forty-five of 54 cases were followed up for the average of 40.3 months. Six cases had ischemic symptoms recurrence in 43 artery embolization patients, in whom 4 cases were cured by endovascular treatment, 2 cases were cured by toe amputation. One case of bypass anastomotic stenosis and one case of stent restenosis were successfully cured by endovascular treatment in 8 arterial thrombosis patients. One cases of below-knee artery stent occlusion in 3 arterial dissection patients was cured by medical treatment. Four cases of amputation patients were followed up in good condition.

CONCLUSIONSMost patients of acute limb ischemia complicated in endovascular therapy could be treated by endovascular therapy. Surgical procedures in time is still the best choice for the patients in whom the endovascular therapy was not satisfied.

Acute Disease ; Aged ; Aged, 80 and over ; Arterial Occlusive Diseases ; therapy ; Atherectomy ; Female ; Humans ; Intraoperative Complications ; prevention & control ; Ischemia ; etiology ; prevention & control ; Lower Extremity ; blood supply ; Male ; Middle Aged ; Retrospective Studies ; Stents

We report a case of erectile dysfunction caused by external iliac artery occlusion, associated with pelvic steal syndrome; bilateral internal iliac arteries were patent. The patient stated that he had experienced erectile dysfunction at similar times along with claudication, but he did not mention it before angiography. He expressed that the erectile dysfunction did not last long and that he felt completely okay after the interventional procedure, in addition to his claudication. Successful treatment of the occlusion, by percutaneous transluminal angioplasty and stent implantation, helped resolve erectile dysfunction completely and treat the steal syndrome.
*Angioplasty ; Arterial Occlusive Diseases/*complications/radiography/*therapy ; Erectile Dysfunction/*etiology/*therapy ; Humans ; Iliac Artery/pathology/*radiography ; Intermittent Claudication/complications ; Male ; Middle Aged ; *Stents ; Subclavian Steal Syndrome/*complications/*therapy

BACKGROUNDTotally laparoscopic aortic surgery is still in its infancy in China. One of the factors preventing adoption of this technique is its steep learning curve. The objective of this study was to evaluate the feasibility and safety of laparoscopic surgery for aortoiliac occlusive disease (AIOD).

METHODSFrom November 2008 to November 2012, 12 patients were treated for severe AIOD with a totally laparoscopic bypass surgery at our university hospital. The demographic data, operative data, postoperative recovery data, morbidity and mortality were analyzed and compared with those of conventional open approach.

RESULTSTwelve totally laparoscopic aortic surgery procedures, including two iliofemoral bypasses (IFB), three unilateral aortofemoral bypasses (UAFB), and seven aortobifemoral bypasses (ABFB), were performed. Conversion to open procedures was required in three patients. The mean operation time was 518 (range, 325-840) minutes, mean blood loss was 962 (range, 400-2500) ml, and mean aortic anastomosis time was 75 (range, 40-150) minutes. Compared with conventional open approach for aortofemoral bypasses performed concomitantly during this period, laparoscopic patients required fewer narcotics and a shorter in-hospital stay and earlier recovery. Postoperative complications developed in four patients, including a single patient with transient left hydronephrosis, ischemic colonic fistula and pneumonia, residual aortic stenosis proximal to the anastomotic site, and asymptomatic partial left renal infarction. All patients recovered and were discharged on postoperative Days 7-14 except one patient that died of respiratory failure on Day 46. All grafts were patent with follow-up imaging performed by Duplex examination, with a mean follow-up time of 10.7 (range, 2-61) months.

CONCLUSIONTotally laparoscopic bypass surgery is a feasible and safe procedure for AIOD, but attention needs to be paid to improve laparoscopic skills of vascular surgery in order to minimize morbidity during the learning curve of this advanced procedure.

Adult ; Aged ; Aortic Diseases ; surgery ; Arterial Occlusive Diseases ; surgery ; Female ; Humans ; Iliac Artery ; surgery ; Laparoscopy ; adverse effects ; methods ; Male ; Middle Aged ; Postoperative Complications ; etiology